Drug policy and harm reduction in Mauritius: Some progress but challenges remain

At the end of November, I went on a tour of Mauritius. The country is usually characterised by its idyllic beaches and landscapes. But the reality I saw was rather different.

Mauritius has one of the highest prevalence of drug use per capita, with high rates of heroin injection. The government has so far responded to drug use with harsh punitive sanctions against users and drug offenders in general. The 2000 Dangerous Drugs Act continues to this day to punish people caught for simply drug use with a maximum of 2 years’ imprisonment and/or a fine of a maximum of 50,000 rupees (USD 1,640). As in other parts of the world, this has not led to a decrease in drug use, while a number of negative consequences have emerged, in particular in terms of public health – in 2005, 92% of new HIV infections in Mauritius was among people who inject drugs.

To respond to this worrying trend, some NGOs, in particular Collectif Urgence Toxida (CUT) through PILS, opened the first needle and syringe programme (NSP) in the country – illegally at the time, since the possession of a syringe is considered as a criminal offence under Mauritian drug laws. Methadone maintenance treatment programmes also started opening in 2006. That year also marked a change in the country’s legislation, with the adoption of the HIV and AIDS Act which officially supported NSPs, and providing that a person should not be criminalised on the basis only of possession of a syringe, if the syringe was obtained from an accredited NSP facility. Today, a number of NGOs, as well as the Ministry of Health, are offering a range of harm reduction services across Mauritius.

These harm reduction services have been extremely effective at responding to the public health challenges caused by drug use. In 2013, the incidence rate of new HIV infections among people who inject drugs had already fallen at 44% (from the high levels of 92% only eight years earlier).

However, many challenges remain. When we look at women who inject drugs, 70% of them are infected by HIV. People who inject drugs are also facing an hepatitis C crisis – 97% of them are infected by the virus. When we look at available services, some crucial harm reduction programmes (such as substitution treatment with buprenorphine, overdose prevention with naloxone, hepatitis C treatment, etc.) are still missing, both in the community and in prisons. And with regards to drug laws, there is a clear contradiction between the harm reduction approach promoted by the HIV and AIDS Act and the repressive approach adopted by the Dangerous Drugs Act.

In this context, I was invited by our partner organisation CUT, to conduct a series of trainings on drug policy advocacy and present experiences from around the world around movements for reform. We reached out to a range of key stakeholders in the country, starting with a group of lawyers who seemed to be quite receptive to the idea that drug use should be treated as a health and social issue, rather than a criminal one. Some of them were particularly interested in the policy reform movements around decriminalisation, and those happening in US states and Uruguay to legalise cannabis (a widely used substance in Mauritius), and others offered their help to support CUT’s work.

We then met up with magistrates, police officers and other key judiciary actors. This workshop was a first step at trying to engage these officials in an objective debate around drug policy in order to try and convince them that they do have an important role to play to protect harm reduction and the human rights of people who use drugs.

The final step of my trip was to conduct a civil society workshop on drug policy advocacy. This last workshop was particularly interesting, with a wide range of NGOs attending to discuss the challenges they face and strategies for reform.

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